This is a prospective, single center, multispecialty study that aimed to evaluate the clinical feasibility and safety of single port surgery and NOTES (mainly transanal and transoral surgery) using a novel single port robotic system.
Background: Single port surgery and natural orifice transluminal endoscopic surgery (NOTES) are emerging minimally invasive surgery techniques which can further reduce patient trauma and enhance recovery. However, the wider adoption of these techniques is hampered by the limitation of instrumentation and technical difficulties. Robotic assistance may improve surgical capabilities during single port surgery and NOTES by providing augmented motion precision and manipulation dexterity. Objectives: To evaluate the clinical feasibility and safety of single port surgery and NOTES (mainly transanal and transoral surgery) using a novel single port robotic system. Design: Prospective, single center, multispecialty study consistent with a stage 1 (Innovation) study described in the Innovation, Development, Exploration, Assessment, Long-term Study (IDEAL) framework. Subjects: Sixty consecutive patients with various benign/malignant pathologies indicated for single port colorectal/urologic surgery or transanal/transoral surgery who fulfilled all the inclusion and exclusion criteria will be recruited. Intervention: Single port surgery and transanal/transoral surgery will be performed using the novel single port robotic system. Study Endpoints: Primary: conversion rate and perioperative complications. Secondary: operative time, blood loss, pain scores, analgesic requirement, and length of stay. Hypothesis: The prospective study will provide important information on the feasibility, safety, and effectiveness of the novel single port robotic system in performing single port surgery and NOTES in various surgical specialties. A positive study will provide supporting evidence for continuing development of this new technology.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
63
Robotic single port colorectal surgery; Robotic transanal surgery; Robotic single port urologic surgery; Transoral robotic surgery
Prince of Wales Hospital, The Chinese University of Hong Kong
Hong Kong, China
Conversion rate
An emergent change in the treatment plan to conventional minimally invasive (laparoscopic/endoscopic) surgery (i.e. the use of more than one additional port), multiport robotic surgery, or to open surgery
Time frame: Up to 1 month
Perioperative complications
Complications including intraoperative complications and all complications occurring during the hospital stay or within 30 days after discharge will be graded according to the Clavien-Dindo classification
Time frame: Up to 1 month
Operative time
Time frame: Intraoperative
Estimated blood loss
Time frame: Up to 1 month
Pain scores on a visual analog scale
Time frame: Up to 1 month
Analgesic requirement
Time frame: Up to 1 month
Length of hospital stay
Time frame: Up to 1 month
Completeness of resection
Pathologic examination of the resected specimen for completeness of resection
Time frame: Up to 1 month
Resection margins
Pathologic examination of the resected specimen for resection margins positivity
Time frame: Up to 1 month
Number of lymph nodes harvested
Pathologic examination of the resected specimen (malignant cases)
Time frame: Up to 1 month
Anal continence after transanal surgery
After transanal surgery; using the Cleveland Clinic Incontinence Score (Wexner's Score)
Time frame: Up to 1 year
Fecal incontinence quality of life after transanal surgery
After transanal surgery; using the validated Chinese version of the Fecal Incontinence Quality of Life Scale (FIQL)
Time frame: Up to 1 year
Urinary continence after radical prostatectomy
After radical prostatectomy; assessed by recording the number of pads used per day
Time frame: Up to 1 year
Male sexual function after radical prostatectomy
After radical prostatectomy; using the abridged version of the International Index of Erectile Dysfunction - erectile function domain score (IIEF-EF)
Time frame: Up to 1 year
Renal function after nephrectomy
After nephrectomy; using renal function blood tests for urea and creatinine
Time frame: Up to 1 year
Swallowing function after transoral robotic surgery (TORS)
After TORS; using the MD Anderson Dysphagia Inventory
Time frame: Up to 1 year
Voice function after TORS
After TORS; using the Voice Handicap Index (VHI) 30
Time frame: Up to 1 year
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